Q. Is all cancer inherited?
A. No, the majority of cancer occurs by chance. Only approximately 5-10%, is due to a specific genetic fault (mutation).
Q. Why would I want to know if I’m at increased risk of cancer?
A. Increased cancer screening is often available which aims to detect cancer at an earlier more treatable stage.
Medications may also be available to lower your risk of cancer. For example; Tamoxifen can lower the risk of breast cancer, aspirin lowers the risk of bowel cancer and the combined oral contraceptive pill lowers the risk of ovarian cancer. However, these medications have side effects and you should talk to a doctor before taking them.
In some situations surgery may be available to lower the risk of cancer. Lifestyle changes such as; changes to diet, increasing exercise, and stopping smoking can also reduce the risk of cancer.
Q. Why do I have to have genetic counselling? Can’t I just have a test for the “cancer” gene?
A. The causes of cancer and links to genetics are complicated, there is not just one gene that can cause cancer and even with a ‘normal’ genetic cancer test result you may still have an increased risk of cancer. Genetic counselling explains your personal cancer risk and what genetic cancer testing can tell you. It is also important to recommend appropriate cancer screening. Following genetic counselling some people will decide to continue with genetic testing and some will decide not to.
Q. How does genetic testing work?
A. Genetic testing looks at the DNA code for a specific gene or genes known to be associated with cancer. It provides information about the gene(s) which are analysed and is usually performed on a blood or saliva sample. Results are normally available in 3-4 weeks. There are several different types of testing available including:
- Diagnostic testing. This attempts to find the possible cause of cancer within the family and is best performed on someone who has had cancer. There are 3 possible results:
- Normal. This means no disease-causing mutation is found. There may still be an increased risk of cancer and increased screening may still be recommended.
- Positive. A known cancer-causing mutation is found. Cancer screening can be targeted and relatives can have testing for this mutation.
- Inconclusive. A variant of unknown significance is found. This means the laboratory has found a change in the gene that they cannot interpret. i.e. the result is inconclusive. Cancer screening will be based on the family history.
- Predictive testing. When the familial mutation is known it is possible to give relatives a definitive answer:
- If the mutation is not present, there is no increased risk of cancer.
- If the mutation is found, the individual has an increased risk of cancer. Increased cancer screening and risk reducing options may be helpful.
Q. Should I have genetic cancer testing?
A. If any of the following are true of your family, you may be at an increased risk of hereditary cancer and genetic testing may be of benefit;
- Several relatives with the same type of cancer
- Relatives diagnosed at particularly young ages (usually before age 50)
- Several affected generations
- Individuals who have been diagnosed with multiple cancers
Q. I’ve already had cancer, why would I want genetic cancer testing?
A. Depending on the results, genetic testing may help determine the best type of surgery and chemotherapy for you. In addition, genetic testing can help determine your risk of cancer in future as well as ways to reduce your risk and appropriate cancer screening. Genetic cancer testing can also give your relatives and children information about their cancer risk.
Q. I have more questions but I’m not sure I want genetic cancer testing.
A. One of our Genetic Counsellors would be happy to provide you with a genetic cancer risk assessment and answer any questions that you have. If you decide to have genetic counselling that does not mean you have to have genetic testing.
Q. What is a genetic counsellor?
A. Genetic Counsellors are uniquely trained individuals who specialise in helping individuals and their families understand and manage their risk of inherited cancer.
Q. What will a genetic counsellor do?
A. A Genetic Counsellor will:
- Ask you about your medical and family history of cancer
- Explain how hereditary cancers are passed on in a family
- Determine if you/your family members are at risk for a hereditary cancer syndrome
- Give you information about inherited cancer syndromes
- Discuss cancer screening
- Provide information about genetic testing
- Allow you to make an informed decision on whether genetic testing is right for you
Q. Do I need a referral for genetic cancer testing?
A. No, you do not normally need a referral.
Q .Will you tell my doctor I’ve had genetic cancer testing?
A. Only if you want us to. At GeneHealth UK we are very careful about your privacy and will only share information if you ask us to. If you do ask us, we are always happy to ensure your doctors are fully aware of any genetic cancer testing that has taken place and of any cancer screening recommendations.
Q. I have private health insurance will this cover genetic cancer testing?
A. Most insurance companies will cover genetic testing if you have been diagnosed with cancer and have a 10% risk of having a genetic mutation. We are happy to contact your insurance company to determine whether you are covered.
Q. Are your genetic cancer tests the same as the ones offered by the NHS?
A. Our BRCA1 & BRCA2 genetic cancer tests are the same tests as those offered through the NHS. BowelGene, ProstateGene, OvarianGene and BreastGene are more comprehensive and not yet available through the NHS. The genetic counsellor can provide you with more information.
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